Maryland Department of Health
Environmental Health

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Testing for Blood Lead Poisoning

Why should children be tested for lead poisoning?​

Lead poisoning affects many children younger than 6 y​ears old in Maryland. Lead can harm a child’s brain, causing lifelong learning and behavior problems.          

Lead poisoning has decreased over the years, but there is no safe level of lead.  The only way to know if a child has been exposed is a blood test. 


When is testing for lead poisoning required?

​In ​March 2016, Maryland implemented the Lead-Free Maryland Kids campaign and the updated clinical requirements for blood lead testing of children.  The entire state of Maryland is now considered 'at risk' for lead exposure, for children born on or after 1/1/15.  As a result, all children born on or after 1/1/15 must be tested for lead at ages 12 and 24 months.  Children born before 1/1/15 should continue to be managed according to the 2004 Lead Targeting Plan (which defines specific areas of the State as 'at risk').

The requirements for the Lead Poisoning Screening Program are found in the Code of Maryland Regulations (COMAR) 10.11.04.

The requirements for reporting a bood lead level test to the Maryland Department of the Environment are found in COMAR 26.02.01. 


Are there excep​tions to this​ requirement?

COMAR 10.11.04(H) prov​​ides exceptions for testing due to a parent or guardian's bona fide religious beliefs. 



Information for clinicians

Effective October 1, 2019, the legal definition of an​ elevated blood lead in Maryland is the same as the clinical definition (5 mcg/dL).  The Maryland Department of the Environment has additional information​ for health care providers​.

March 2, 2021 Notice to Maryland Health Care Providders of Changes to Blood Lead Level Testing and Reporting Requirements, and New Resources for Providers and Parents

June 7, 2012 Health Care Provider Letter Adopting a Revised Maryland Department of Health Guidelines for Clincal Assessment and Management of Childhood Blood Lead Levels

Regulations for Childhood Lead Testing (COMAR 10.11.04)

MDH Form 4620 Blood Lead Testing Certificate for Schools, Child Care

2012 Centers for Disease Control and Prevention Updated Lead Testing Guidance 

​2020 Updated Guidelines for Assessment and Management of Childhood Lead Exposure 

2016 Guidelines for Assessment and Management of Childhood Lead Exposure

Final Report on Blood Lead Point of Care Testing (2014)​


For additional medical resources, contact:
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New Home Visiting and Lead Abatement Programs for Families

Maryland has two new programs for families with a child exposed to lead:

The Healthy Homes for Healthy Kids Program removes lead hazards from the home at no cost.

The Childhood Lead Poisoning Prevention and Environmental Case Management Program provies in-home  services to reduce exposures to lead and to asthma triggers.

Learn more about these programs, including eligibility criteria and availability in your jurisdiction.


Learn m​ore

Visit the Lead Poisoning Prevention website​ for additional information and resources for clinicians and parents.






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